Our Shih Tzu Health and Breed Tendency center aims to provide comprehensive information about potential breed and health tendencies. It is important to note that NONE of the health or breed tendencies listed are unique to Shih Tzu; however, reducible umbilical hernias are the most prevalent and commonly observed in this breed.
​This page serves as a valuable starting point for your research and is written from a practical perspective, drawing on the expertise of experienced Shih Tzu breeders and owners. It is worth noting that many of the conditions listed can be fully treated, or the puppy may naturally outgrow them. Furthermore, only a few of the health or breed tendencies mentioned pose a life-threatening risk or result in lifelong illnesses. It is unlikely that your Shih Tzu will experience more than one or two of these tendencies. Nevertheless, it is essential to be aware of them as a responsible and informed Shih Tzu owner.

Symptoms: 

• Scratching/ Itching
• Rust/ Brown colored paws
• Rust/Brown colored spots/patches on stomach area
• Constant ear infections
• Itchy, watery or red eyes
• Hives or Sores
• Sneezing
  
• Swelling (Facial area or ears)
  
• ​Inflammed skin
  

Symptoms: 

• Scooting or Scratching rear end along the ground
• ​Dog has been already been treated for fleas/tapeworm (similar symptoms)
• Biting at tail or hind end
• Foul Smell coming from hind end
• Discoloration/redness of anal sacks ( located under tail)
• Tail chasing, spinning
  
• Straining or Painful defecation
  

Symptoms:

• Outward bowing at the knee
• Lower legs are angled inward giving the  appearance of a "bow"​
  
• Characterized by short legs and heavier chest
  
• Commonly seen in bulldogs
  
• Loose kneecaps/joints
  
• Depending on severity and age, the dog will have a progressivly harder time jumping, running and playing
  

Symptoms:

• Diarrhea, often watery ( mild is not a concern, profuse or constant may need fluids or vet intervention)
• Some blood or mucus in stool
• Distinct smell in stool
• Dehydration
• Weight loss/ lethargy (more severe cases)

Symptoms:

• Most often seen in puppies, who eat their own poop 
• Eating feces of other animals

Eating feces of wildlife  or other animals without the puppy being fully vaccinated can be harmful/deadly

• Smelly breath/mouth "evidence" stuck to hair
• Stool disappearing shortly after a bowl movement

Symptoms:

• There are several different types
• Wart or pimple like appearance
  
• Depending on type can be hard or soft
  
• Often located in back or legs, can be located in other areas
  
• For young dogs the "wart" like cysts are contagious and can be spread in close contact situations such as doggy daycare or dog parks
  
• For older Shih Tzu, these bumps become more common as they age and are often called "old lady" or "old man" bumps
  

Symptoms:

• Dry, flaky skin
• Itching, scratching or similar discomfort
  
• Red, yeasty smelly skin
  
• Hair loss, patchy hair
  
• Often accompanied by allergies
  

Symptoms:

• Breed Standard Shih Tzu bite compared to other types of bites
• Retained Baby Teeth
• Dental Care at Home
• Dental Disease Symptoms:
• Decreased interest in eating dry food.
  
• Decreased interest in hard treats.
  
• Chewing more slowly than usual.
  
• Dropping food from the mouth while chewing.
  
• Excessive drooling.
• Sensitivity to having face or mouth touched

Symptoms:

• Heading shaking
• Scratching at ears
  
• Matted hair around ears 
  
• Red, irritated skin
  
• Yeast or waxy build up inside ear
  
• Dark discharge/ear fluids
• Smell
  

Symptoms:

Most Common Eye issues:
Eye Ulcer:

• Blinking excessively or shutting the affected eye
• Significant tearing or discharge from the eye
• Redness and/or swelling of the tissues surrounding the eye
• Significant discoloration of the eye when open- often blue or white tinged.
• Painful yelping/crying or hiding

Dry Eye:

• Redness around the eyes
• Mucous production (usually yellowish)
• Lack of regular tear production
• Brownish tint to the eye surface

Excessive blinking

• Discharge of mucus, pus, or liquid from the eye
• Rubbing at the eyes and whining

Loss of vision (severe circumstances)
Distichiasis (In Grown lashes):

• Constantly wet face
• Squinting
• Watery Eyes

Symptoms:

• Diarrhea, with mucus and sometimes small amounts of blood
• Loose, watery stool
• Abdominal discomfort
• Slower growth/lethargy ( very severe cases)
• No Symptoms (  Mild or asymptomatic cases)

Symptoms:

Heat Stroke in Dogs:

• Rapid panting
• Snorting, drooling
• Difficulty breathing
• Anxious
• Lethargic, drowsy or uncoordinated​

Hypothermia in Dogs:

• Low blood pressure
• Lethargy 
• Shivering/curling up for warmth
• Muscle Stiffness
• Inability or difficulty swallowing

Symptoms:

• Heart Murmurs are graded on a 1-6 scale
• Puppies can outgrow a level 1-2 heart murmur
  
• Irregular heartbeat

Signs of heart disease:

• Irregular heartbeat.
• Hacking, persistent cough.
• Excessive panting even when resting.
  
• Tires easily.
• Lack of energy.
• Collapses or faints.
• Gums and/or tongue are bluish in color.
• Racing pulse.

Symptoms:

Hernias in puppies are separated into two categories: Umbilical hernias and Inguinal Hernias.

Umbilical Hernias: (Reducible)

• Small bump/lump on the belly button location
• Similar feeling and looking to an "outie" belly button in humans
  
• Soft, squishy, pushes in
  
• May reduce or even fully recede to an "innie" belly button as the puppy grows.
  

Inguinal Hernias: 

• Small bump/lumps in the groin areas, can be on one or both sides
• May be "fat pockets" and though a vet will likely call them inguinal hernias, fat pockets fully recede on their own by 8 months of age
  
• Located on one or both sides of the groin
  
• Soft, squishy and can be pushed in
  

Symptoms:

• Disorientation, wobbly gait
• Pale gums, pale tongue
• Dehydrated
• Typically not eating/drinking on their own
• Shivering, shaking, trembling
• Sleepy, or unconscious
• Progress into seizures, coma or death
• This is a Medical Emergency- You need to start restoring sugar slowly and may need to call the vet/ emergency.  

Symptoms:

• Diarrhea, with or without blood or mucus. Otherwise loose stool.
• Scooting.
• Vomiting.
• Distended abdomen (belly)
• Weight loss.
  
• Decreased activity.
  
• Dull coat

Symptoms:

Elevated liver values:

• Often observed during bloodwork performed at the time of spay
• Often fully correctable with diet change
• Vets will often warn that these are indicative of a liver shunt or liver disease, but typically just the result of high protein food/ too many treats

Liver Shunt Signs:

• Stunted growth, poor muscle development
  
• Abnormal behaviors such as disorientation, staring into space, circling or head pressing, and seizures.
  
• Drinking or urinating too much, vomiting, and diarrhea.

Symptoms:

• Kneecap pops out or is loose
• Bowlegged stance in the hind limbs.
• Cracking or popping noises when the knee is bent.
•  In most small breed dogs, this movement occurs medially or toward the inside of the limb. 
• Rated on gradation system 

Symptoms:

• Dew claws may be located on both front and back feet
• Some breeders remove but we no longer do so because of health research showing a need for them.
  
• May need to be clipped slightly more frequently.
  

Symptoms:

• Weight gain
• Little or no waistline
• Low or no energy
• Becoming excessively winded with small amounts of activity.  
• No palpable ribcage
• Excess body fat
• Distended abdomen
• Lack of mobility
• Lethargy
• Difficulty breathing
  

Symptoms:

• Soft Spot like a newborn baby
• May be very tiny in size, up to the size of a quarter.  The size of a dime or smaller is "average".
  
• ALL puppies are born with a soft spot in order for the Mom to be able to deliver which gradually closes.
  
• Some puppies soft spots are fully closed at 8-10 weeks, but small to tiny puppies may take up to 6 months to close totally.
  
• Does NOT make a puppy more prone to Hydrocephalus
  

Symptoms:

Early Signs:

• Fever/ Temperature 
• Lethargy
• Lack of appetite
• Rapid weight loss
• Dehydration

As it progresses:

• Severe, almost constant Diarrhea, typically accompanied by blood and often mucus as well.
• Severe weight loss and inability to keep down food
• Severe Dehydration, inability to keep down fluids or drink on their own.
• ​This is a medical emergency and you need to go to the Emergency room.  Puppies rarely survive Parvo   

Symptoms:

• Loud snorting or honking sound, may sound like a coughing or gagging fit
  
• Since the dog is inhaling ear rather than exhaling, it appears the dog is having a hard time breathing or in possible respiratory distress
  
• May sound like chocking or snorting
  
• If you have not witnessed this or think you may have seen this- watch Youtube videos because there is a variance in the presentation. 

Symptoms:

• Snoring may be temporary ( during teething), intermittent ( when the dog is in a deep sleep) or a regular occurrence.
• Snorting, honking, sneezing, throat clearing, light gagging are all noises familiar to Shih Tzu owners.  They are seen most frequently during teething. 
  
• Some dogs continue to make them after teething when scared, excited, or anxious
  

Symptoms:​

Stenotic Nares:

• Typically present at birth
• Puppies struggle to nurse as they are unable to breathe and nurse at the same time.
• High mortality rate of newborn/very young puppies who are unable to nurse.
• Extra skin flap located in one or both nostrils

Tight Nostrils during teething:

• Swollen, tight nostrils
  
• Snorting, snuffling, honking ​
• More reverse sneezing and snoring during this time period
• Clear discharge
• Appearance of allergy like symptoms
• Gradual opening of the nostrils as the puppy grows- some puppies nostrils up very suddenly 

Symptoms:

Gall Stones:

•  Vomiting.
• Abdominal tenderness to touch.
• Abdominal pain.
• Jaundice (yellowing of skin or eyes)
• Fever.
• Lethargy.
• Loss of appetite

Bladder Stones:

• Blood in urine
• Difficulty defecating 

Symptoms:

• Visible discoloration of the fur, typically red/brown rust colored stains
• Wet appearance, sometimes with discharge
  
• Smell/ Oder
  
• Stains often also seen around mouth 
  

Symptoms:

Tight nostrils/Snoring/Snorting/ Reverse Sneezing- See above for symptoms

Deciduous teeth (retained baby teeth)

• Baby teeth often come in later and slower than other breeds
• Dogs have two sets of teeth in their lifetime. Puppies have 28 deciduous teeth also known as primary, baby, or milk teeth. Adult dogs have 42 permanent teeth, also known as secondary teeth. Most dogs start teething at about 3.5-4 months of age and have completed teething by 6-7 months of age, but Shih Tzu tend to be slow at teething and often have a couple or more retained baby teeth. Vets can remove retained at the time of spay/nueter or wait a little longer for them to fall out on their own.  

Symptoms:

• Discomfort and local swelling/lump at the vaccination site
• Mild fever
• Decreased appetite and activity, drowsiness 
• Sneezing, mild coughing, "snotty nose" or other respiratory signs may occur 2-5 days after your pet receives an intranasal vaccine
• A small, firm swelling under the skin may develop at the site of a recent vaccination, which should decrease in size gradually resolving itself.
• More severe reactions may including hives, wheezing, severe swelling UP to life threatening reactions.
• The possibility of vaccine reactions, including severe reactions is why we ask that vaccines are given ONLY ONE at a time. 

Symptoms:

• There are multiple types of vomiting and symptoms and treatment vary according to type
• Bilious Vomit (Most common in puppies): Yellow, frothy fluids, often also mixed with what appears to be clear saliva like fluid.
• Frothy Vomit (common in puppies and young dogs), typically from eating too fast and often accompanied with some coughing, honking or reverse sneezing 
• Food Vomit:  Vomit accompanied with undigested food
• Mucus Vomit: Vomit accompanied by mucus, stool typically also has mucus
• Hematic Vomit: Vomit with blood in it.
• Grass/ Feces Vomit: Typically clear or some froth with pieces of grass or feces in it

Health/ Breed Tendencies
(Most are puppy ailments)

​Our mission is to find caring forever homes for healthy, happy Shih Tzu puppies. We understand that as a potential pet owner, you desire a Shih Tzu puppy to become a cherished part of your family for many years. Before considering bringing a new puppy home, it is essential to familiarize yourself with the breed's health and tendencies.
Fortunately, some of the breed tendencies we discuss may not affect your puppy, or they may outgrow them before reaching adulthood.
Regardless of their size, our Shih Tzu have an estimated lifespan of 11-16 years. A well-bred smaller-sized Shih Tzu from a reputable breeder will have a lifespan no shorter than that of a standard-sized Shih Tzu. These smaller Shih Tzu are simply miniature versions of the standard size and share the same lifespan and health issues/ breed tendencies. Shih Tzu are closely related to wolves, which contributes to their overall health. However, like all dogs, Shih Tzu may be more prone to certain health conditions and breed tendencies.
The health concerns listed here are relatively common in small and toy dog breeds. However, this information specifically focuses on purebred Shih Tzu. Mixed breed Shih Tzu may have different health concerns.
As a devoted pet owner, the best thing you can do for your furry family member is to be an informed one. Don't hesitate to ask questions, read, and educate yourself. Starting with a high-quality puppy from a responsible and reputable breeder is just the first step.
We provide a one year health guarantee against life-threatening inherited genetic defects for all our dogs.  Our puppies are carefully bred from superior breeding stock. Most of them come from multiple generations of our own lines, and when we do introduce outside lines, we ensure they come from experienced breeders who prioritize health and quality.
Furthermore, all our puppies come with a lifetime advise and we are always available to answer any questions you may have about our adorable babies.
While the health issues and breed tendencies we discuss are not exclusive to Shih Tzu and are common among many other toy breeds or flat-faced dogs, we have noticed that Shih Tzu often react differently to these conditions. This page aims to highlight how these ailments or tendencies affect Shih Tzu specifically. It's important to remember that not all veterinarians are familiar with these breed tendencies or common puppy ailments, and misdiagnoses can occur. Veterinarians, like human doctors, are general practitioners who encounter various breeds, with mixed breeds comprising the majority of their patients. Many of the health issues discussed here primarily relate to raising a Shih Tzu puppy, and most of these issues tend to resolve themselves by adulthood, which may differ from other breeds.